The need for telemedicine: a perfect storm
Three aspects combine to create a ‘perfect storm' for telemedicine to thrive in the Middle East:
Number of Beds per 1,000 People
France & Germany
Number of Nurses per 1,000 People
Figure 5.1 Comparison of healthcare resource availability. Source: Prepared by the author based on the data available at De Boysson, T. & Kliouri, R. (2018)
- • Undersupply: The above statistics on insufficient access along with an undersupply of tertiary care across UAE and the Kingdom of Saudi Arabia (De Boysson & Kliouri 2018).
- • Young population: In addition, the MEA region's average age is quite young at 28.2 years old (Worldometer 2020).
- • Mobile and internet penetration: The Middle East has one of the world's highest internet penetration rates and largest expected mobile users. This can be gleaned from Global System for Mobile Communications (‘GSMA’) figures available over the internet (GSMA 2019a).
In addition, 344 million mobile phone internet users are expected by 2025 (a penetration rate of 52%) across the market at a CAGR of 5.4% (GSMA 2019a).
The above statistics create a perfect storm for telemedicine, where an extremely connected population with a high comfort with mobile phone internet and good infrastructure are faced with a shortage of doctors, nurses and tertiary care.
While government across the GCC and wider Middle East are alert to this, the most efficient and quick-to-market solutions involve telemedicine.
Telemedicine in the context of this chapter includes:
- • Preventative: for example, fitness trackers and apps; diabetes prevention tools, etc.
- • Specialist tech: for example, blockchain electronic medical record (‘EMR’) solutions for hospitals.
- • Accessibility solutions: for example, the ease of booking a doctor and ease of reaching them via video link.
The MEA telemedicine market size is estimated to grow from $3.48 billion in 2019 to $5.22 billion in 2024, with a CAGR of 10.8% over the next five years (Market Data Forecast 2020).
There has been an increase in focus in healthcare start-ups across the region (Magnitt 2019). The majority of start-ups around 2017-18 focused on booking platform aggregators with a rising consensus that the population was not ready or interested in ‘video consultations’.
The ‘boom’ of booking and aggregator start-ups is also explained by the high barriers to entry for start-ups into the world of EMRs, electronic health records (‘EHRs') and other solutions that hospitals need.
While the number of deals within healthtech has risen every year in the start-up ecosystem, the total size of deals was highest in 2017.
With the COVID-19 crisis and the strain on hospitals and supply chains, this is expected to drastically change in the coming years. In addition, new deals and incursions into Al with US-based firms moving into the internet of medical things (‘IOMT’) space will see the start-up scene in healthtech boom drastically.
Most healthtech deals, however, due to lack of research and development (‘R&D’) as outlined below, will be of ‘scale-ups’ or larger companies from abroad moving into MEA and establishing offices. An example is the telemedicine platform Vsee, which reported expansion attempts, and the emergence of MMG-AI - a Spanish-based Al company with an increasing presence in Saudi Arabia and UAE. As start-ups founded in the West find an unfulfilled market need, coupled with great infrastructure and a ‘blue ocean’, it is highly likely that they will use their superior European or US-based R&D teams to capture volume in the region. While this is a welcoming development for healthtech, it may not be the best outcome for a nascent start-up ecosystem.
The COVID-19 acceleration
COVID-19 has brought a sharp focus on healthcare in general. This also meant that telemedicine and its adoption has accelerated. Of the five largest booking platforms in the region, all of them are now offering video consults with their doctors - this includes Okadoc, DrFive.com, Oladoc and Meddy.com - a plan that was at least six months if not more down the line has now been brought forward due to COVID-19. The acceleration will continue and is expected to take us into a new world where the trip to the doctor is taken only for the most necessary of problems.
Currently, video consultations have increased drastically across the region -soon, this will spill into vital signs and other aspects of a person’s health also being reported from home - the days of going to a doctor for ‘niggles’ and slight headaches are already far behind us. This will be a great cost and capacity savings for hospitals - but also means doctors need to be trained and tooled for this new change. In addition, internet of things (‘IoT’) devices monitoring at-home care present a new frontier of investments.